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ASP substances such as capsules, heat sticks and herbal cigarettes)

Laboratory evaluation revealed elevated adrenocorticotropic hormone (ACTH) levels, raising the possibility of an underlying endocrine abnormality and prompting consideration of an association with Cushings disease, a relationship that has been infrequently reported in the literature

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Because of these limitations, the team cautions against drawing firm conclusions and encourages conducting more long-term studies to truly understand how vaping and dual use affect diabetes risk